Obscure gastrointestinal bleeding resulting from small bowel neoplasia; A case series.

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  • Additional Information
    • Publication Year:
      2019
    • Author-Supplied Keywords:
      Case report
      Gastrointestinal stromal tumour
      Neuroendocrine tumour
      Obscure gastrointestinal bleeding
      Small bowel
    • Abstract:
      • Obscure GI bleeding can be a challenging diagnosis and is well acknowledged. • Perseverance is required to achieve the correct diagnosis in obscured GI bleeding. • Diagnostic overshadowing can halt investigations and delay diagnosis. • Multidisciplinary team input is important in the diagnosis of obscured GI bleeding. Undiagnosed gastrointestinal bleeding may originate in the small bowel. This presents a diagnostic challenge despite the advancement in contemporary imaging. We report two cases which highlight the limitations of routine investigation for obscure gastrointestinal bleeding. Patient A presented with a history of rectal bleeding, treated with interventional embolisation of caecal angiodysplasia. A diagnosis of neuroendocrine tumour (NET) was reached two years after presentation following intraoperative right hemicolectomy resection of a presumed recurrent angiodysplastic bleed. Patient B presented with recurrent melaena labelled as non-steroidal anti-inflammatory drug (NSAID) induced gastritis. After multiple endoscopic and radiological investigations, a 4.5 cm mass was visualised on imaging after three years, which was histologically proven as gastrointestinal stromal tumour (GIST) of the small bowel. Both patients experienced a delayed diagnosis despite multiple investigations and careful follow-up. Our case series discusses the benefits and limitations of investigation for gastrointestinal bleeding and suggests a need for continued multidisciplinary input in situations where the patient presumed diagnosis remains in question. OGIB remains a diagnostic challenge and is attributable to small bowel pathology in 75% of cases. This suggests a need for continued investigation in situations where the patient presents multiple times despite adequate treatment for the presumed underlying condition. [ABSTRACT FROM AUTHOR]
    • Abstract:
      Copyright of International Journal of Surgery Case Reports is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
    • ISSN:
      22102612
    • Accession Number:
      137560669
  • Citations
    • ABNT:
      TEH, J. W. et al. Obscure gastrointestinal bleeding resulting from small bowel neoplasia; A case series. International Journal of Surgery Case Reports, [s. l.], v. 60, p. 87, 2019. Disponível em: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=edo&AN=137560669&custid=s6224580. Acesso em: 28 jan. 2020.
    • AMA:
      Teh JW, Fowler AL, Donlon NE, et al. Obscure gastrointestinal bleeding resulting from small bowel neoplasia; A case series. International Journal of Surgery Case Reports. 2019;60:87. http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=edo&AN=137560669&custid=s6224580. Accessed January 28, 2020.
    • APA:
      Teh, J. W., Fowler, A. L., Donlon, N. E., Khan, W., Khan, I. Z., Waldron, M., & Barry, K. (2019). Obscure gastrointestinal bleeding resulting from small bowel neoplasia; A case series. International Journal of Surgery Case Reports, 60, 87. Retrieved from http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=edo&AN=137560669&custid=s6224580
    • Chicago/Turabian: Author-Date:
      Teh, Jia Wei, Amy L. Fowler, Noel E. Donlon, Waqar Khan, Iqbal Z. Khan, Michael Waldron, and Kevin Barry. 2019. “Obscure Gastrointestinal Bleeding Resulting from Small Bowel Neoplasia; A Case Series.” International Journal of Surgery Case Reports 60 (July): 87. http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=edo&AN=137560669&custid=s6224580.
    • Harvard:
      Teh, J. W. et al. (2019) ‘Obscure gastrointestinal bleeding resulting from small bowel neoplasia; A case series’, International Journal of Surgery Case Reports, 60, p. 87. Available at: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=edo&AN=137560669&custid=s6224580 (Accessed: 28 January 2020).
    • Harvard: Australian:
      Teh, JW, Fowler, AL, Donlon, NE, Khan, W, Khan, IZ, Waldron, M & Barry, K 2019, ‘Obscure gastrointestinal bleeding resulting from small bowel neoplasia; A case series’, International Journal of Surgery Case Reports, vol. 60, p. 87, viewed 28 January 2020, .
    • MLA:
      Teh, Jia Wei, et al. “Obscure Gastrointestinal Bleeding Resulting from Small Bowel Neoplasia; A Case Series.” International Journal of Surgery Case Reports, vol. 60, July 2019, p. 87. EBSCOhost, search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=edo&AN=137560669&custid=s6224580.
    • Chicago/Turabian: Humanities:
      Teh, Jia Wei, Amy L. Fowler, Noel E. Donlon, Waqar Khan, Iqbal Z. Khan, Michael Waldron, and Kevin Barry. “Obscure Gastrointestinal Bleeding Resulting from Small Bowel Neoplasia; A Case Series.” International Journal of Surgery Case Reports 60 (July 2019): 87. http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=edo&AN=137560669&custid=s6224580.
    • Vancouver/ICMJE:
      Teh JW, Fowler AL, Donlon NE, Khan W, Khan IZ, Waldron M, et al. Obscure gastrointestinal bleeding resulting from small bowel neoplasia; A case series. International Journal of Surgery Case Reports [Internet]. 2019 Jul [cited 2020 Jan 28];60:87. Available from: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=edo&AN=137560669&custid=s6224580